20 Year Experience of Zirconia Total Hip Replacements

Clarke, Ian C.; Green, D. D.; Pezzoti, G.; Donaldson, David

doi:10.1007/3-7985-1540-9_12

Cited by 8 publications

(6 citation statements)

References 28 publications

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“…The cup contains an inlay as an articulation interface. For the estimated 1.4610 6 replacements performed worldwide every year [2], according to Dietrich et al [3], approximately 25 per cent of primary THR bearings are ceramic-on-polyethylene types and 10 per cent are ceramic-on-ceramic types, with increasing percentages expected in the next few years.…”

Section: Introductionmentioning

confidence: 99%

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Influence of contaminants in the stem—ball interface on the static fracture load of ceramic hip joint ball heads

Weisse

Affolter

Stutz

et al. 2008

Proc Inst Mech Eng H

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The probability of in-vivo failure of ceramic hip joint implants is very low (0.05-0.004 per cent). Besides material flaws and overloading, improper handling during implantation may induce fractures of the ceramic ball head in the long term. This study focuses on the influence of contaminants located in the stem-ball interface and on the use of damaged metal tapers on the strength of ceramic ball heads. Mechanical tests on alumina ball heads according to the standard ISO 7206-10 were performed to identify their effect on the static fracture load. A decrease of up to 90 per cent with respect to the reference static fracture load was found when contaminants such as bone chips, soft tissue, or blood were present. Reductions of 57 per cent and 27 per cent were observed for deformed stem cross-sections (from circular to elliptical) and for flattened stems respectively, making deformed stems another influential parameter. Since any alteration of the interface between the metal taper and the ceramic ball head yields a nonuniform load introduction and hence results in stress concentrations, its presence has to be avoided.

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Section: Introductionmentioning

confidence: 99%

“…The mid-1980s marked the entry of zirconia into orthopaedics. Yttria-stabilized zirconia offers higher strength and higher fracture toughness associated with similar biocompatibility to that of alumina [6][7][8]. The focus of this work, however, is solely on alumina femoral heads.…”

Section: Introductionmentioning

confidence: 99%

Influence of contaminants in the stem—ball interface on the static fracture load of ceramic hip joint ball heads

Weisse

Affolter

Stutz

et al. 2008

Proc Inst Mech Eng H

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“…Zirconium (Zr) is a sturdy transition metal that received special interest in different biomedical fields due to its physical features that resemble those of titanium [90]; nevertheless, bulk Zr is not currently used to produce orthopedic implants. However, Zr alloys and zirconium dioxide (ZrO 2 ), commonly known as zirconia, are widely employed in orthopedics for joint replacement [91], but also in dentistry for dental crown reconstruction and dental implants [92,93] due to its good biocompatibility and high fracture strength [94]. Different from other oxides, there is currently a lot of debate about whether ZrO 2 NPs have a toxic activity against bacteria and fungi.…”

Section: Transition Metal Nps With Antimicrobial Activity For Potementioning

confidence: 99%

A Precautionary Approach to Guide the Use of Transition Metal-Based Nanotechnology to Prevent Orthopedic Infections

et al. 2019

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The increase of multidrug-resistant bacteria remains a global concern. Among the proposed strategies, the use of nanoparticles (NPs) alone or associated with orthopedic implants represents a promising solution. NPs are well-known for their antimicrobial effects, induced by their size, shape, charge, concentration and reactive oxygen species (ROS) generation. However, this non-specific cytotoxic potential is a powerful weapon effective against almost all microorganisms, but also against eukaryotic cells, raising concerns related to their safe use. Among the analyzed transition metals, silver is the most investigated element due to its antimicrobial properties per se or as NPs; however, its toxicity raises questions about its biosafety. Even though it has milder antimicrobial and cytotoxic activity, TiO2 needs to be exposed to UV light to be activated, thus limiting its use conjugated to orthopedic devices. By contrast, gold has a good balance between antimicrobial activity as an NP and cytocompatibility because of its inability to generate ROS. Nevertheless, although the toxicity and persistence of NPs within filter organs are not well verified, nowadays, several basic research on NP development and potential uses as antimicrobial weapons is reported, overemphasizing NPs potentialities, but without any existing potential of translation in clinics. This analysis cautions readers with respect to regulation in advancing the development and use of NPs. Hopefully, future works in vivo and clinical trials will support and regulate the use of nano-coatings to guarantee safer use of this promising approach against antibiotic-resistant microorganisms.

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“…Yttria-stabilized zirconia polycrystalline (Y-TZP) ceramics possess unique properties that make them suitable for tribological applications, such as high resistance to wear, high hardness and, particularly, a high fracture toughness compared to other ceramic materials, as well as high resistance to plastic deformation, high compressive strength and thermal and chemical stability [1][2][3]. Among some of their most important engineering applications are their implementation as structural elements for replacement of biological systems in the human body as hip joint implants and dental prostheses.…”

Section: Introductionmentioning

confidence: 99%

Influence of relative humidity and low temperature hydrothermal degradation on fretting wear of Y-TZP dental ceramics

Borrell

Gil

Presenda

et al. 2019

Wear

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Dental pieces are subjected to constant friction due to grinding during mastication and mouth disorders such as bruxism. Therefore, wear resistance of Y-TZP materials used for dental prostheses must be investigated. In this work, the influence of humidity and low temperature hydrothermal degradation (LTD) in 3Y-TZP ceramics subjected to fretting has been evaluated. A 100% r.h. reduces the effects of wear due to the lubricative effect of water, compared to those at ambient r.h. COF, wear volume and damage are considerably lowered at a r.h. of 100%.Exposure to degradation conditions for 25 h increased the vulnerability to wear damage of LAVA grade Y-TZP sintered at 1400 °C since the critical grain size of 300 nm was exceeded.

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20 Year Experience of Zirconia Total Hip Replacements

Cited by 8 publications

References 28 publications

Influence of contaminants in the stem—ball interface on the static fracture load of ceramic hip joint ball heads

Influence of contaminants in the stem—ball interface on the static fracture load of ceramic hip joint ball heads

A Precautionary Approach to Guide the Use of Transition Metal-Based Nanotechnology to Prevent Orthopedic Infections

Influence of relative humidity and low temperature hydrothermal degradation on fretting wear of Y-TZP dental ceramics

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